Registration for Diagnostic Video Session

Video Call | 35 min | €85,-

With the Diagnostic Video Session you will receive:

in-depth analysis, conclusions and discussion of your present condition
the prognosis for your recovery
explanation of the basics of facial palsy, its residuals and complications
giving you the recommendations on how to start relieving the symptoms that are bothering you most
answering your questions

Please fill in the registration form below to request the Diagnostic Video Session of your face. After we assess your registration, we will send you an email with the following steps, including payment and available time slots.

If you have any questions or concerns please send us a message at [email protected].

Full name:

Email:

Date of birth (dd/mm/yyyy):

Your country and city of residence:

Contact phone number:

Date of the facial palsy onset (dd/mm/yyyy):

What had caused your facial palsy:
CongenitalOperation (surgery)TraumaHerpes virus (Ramsay Hunt)Last weeks of pregnancyUnknown reason (Bell's palsy)Other. Please specify:

Affected side:

What treatments/medication did you take during the acute period?

Which therapy was prescribed and taken?

When did the first signs of recovery appear?

When did the improvements slow down or eventually stopped?

What treatments did you take during the last 3 months, what were the results:

What complaints about your face and facial movements do you have at the moment (as detailed as possible):

Comments or questions:

I have read and accept the Terms & Conditions
I would like to be added to Crystal Touch newsletter and receive further news and occasional offers

After submitting the form, you will receive an auto-reply with confirmation and further details to your email (please also check the spam folder).

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Privacy notice: The information submitted will remain private and will be available only to the members of the Crystal Touch team. This information will be used only for the purpose of this analysis unless requested otherwise by you. The information and photos are not shared with any third party or anyone else outside of Crystal Touch without your permission. Read the Terms & Conditions for more details.